HomeMy WebLinkAboutMiscellaneous - 250 SOUTH BRADFORD STREET 4/30/2018 (2)Lot & Street. 6 _1 _'� - !� Map/Parcel C
CONSTRUCTION APPROVAL
Has plan review fee been paid: PYES NO Permit# //60
Plan -Approval:- Date: / Approved by:
Designer.-==(� Plan Date:
Conditions:.-
_Water_Supply - Town - -- ` Well
Well Pemut: -- -_ Driller:
Well Tests: --Chemical Date Approved
Bacteria I Date Approved
`Bacteria IIDate Appro ed
Plumbing. Sign -Off: - Wiring Sign -Off:
Comments:�
Form,...."U"__Approval: Approval to Issue:
NO
Date -Issued - By: �t/V
- onditions
-Conditions-
Final Approval:
Final
All Permits. Paid?
NO
Well Construction Approval? YES
NO
Septic System Construction Approval?C,
NO
Certification? YES
NO
Other Yks
NO
Any Variance Needed? YES
:1
FINAL BOARD OF HEALTH APPROVAL:
_
DATE:_ 2
{
APPROVE BY:
i
•
SEPTIC SYSTEM INSTALLATION
Y
Is the installer licensed?
YES
NO
_
Type of Construction:
+ . W
REPAIR
New Construction: Certified. Plot Plan Review
._ YES
NO
Floor -Plan Review
— YES
NO
Conditions of Approval from Form U - YES
NO
Issuance of DWC permit: _ -
— YES
NO
DWC Permit Paid? __
DWC Permit #14;,43_
— YES NO
Installer:,
-=
Begin Inspection-
Excavation Inspection:
Needed:
Passed: lv._ By:
Construction Inspection:
Needed: -
'1 Satisfactory:_-
0
a pproval of Backfill:-- Date: By: f
v' Lu Final Grading Approval: --Date: -.? By:
Final Construction Approval: Date: 7 BBy:
Certificate of Compliance: Approval: Date:
MAP . LOT # __
'
PARCEL # STREET 'SO
CONSTRUCTION APPROVAL
HAS PLAN REVIEW FEE BEEN PAID?
PL -AN APPROVAL: APP. B
DESIGNER: PLAN DATE'
CONDITIONS
................ ...... ... ...... ... ... .... ...... _
WATER SUPPLY: WELL
WELL PERMIT DRILLER____________
WELL TESTS: CHEMICAL DA)E APPROVED________
BACTERIA I DATE 01 -PROVED _
BACTERIA II DA -[E APPRUyED_____ _
COMMENTS:
FORM U APPROVAL: APPROVAL TO ISSUE
DATE ISSUED
CONDITIONS:
FINAL APPROVAL:
ALL PERMITS PAID
WELL CONSTRUCTION APPROVAL
SEPTIC SYSTEM CONSTRUCTION APPROVAL
OTHER
ANY VARIANCE NEEDED
FINAL BOARD OF HEALTH APPROVAL:
YES NO
YES
NO
YES
NU
YES
NO
YES
NU
YES
NO
DATE:_______
_8Y:_____
s^^'
SEPT I C. _SYSTE.MI N.. STR..4.L.A.T.I.SN.
IS THE INSTALLER LICENSED?
YES
NO
TYPE OF CONSTRUCTION:
NEW
REPAIR
•, NEW CONSTRUCTION: CERTIFIED
PLOT PLAN REVIEW
YES
NO
CONDITIONS
OF APPROVAL
YES
NO
(FROM FORM
U)
ISSUANCE OF DWC PERMIT
YES
NO
DWC PERMIT NO.
INSTALLER :
_•_..•_._.,_:
BEGIN INSPECTION YES N0:
EXCAVATION INSPECTION: -NEEDED:--..
PASSED
BY
CONSTRUCTION INSPECTION:
NEEDED: _.__.._._._._..:_...._...___........._. ___._.
_._._..........__.___._._._._......__.....__.:
AS BUILT PLAN SATISFACTORY:
YES:
APPROVAL. TO BACKFILL: DATE:
.,__HY___..,___._.....
_................ �__._.
FINAL . GRADING APPROVAL: DATE
___BY.__
FINAL CONSTRUCTION APPROVAL:
DATE:_._._____.___�___.BY_^_,_._.-____
1739
APPLICATION FOR SEWER -SERVICE CONNECTION
North Andover, Mass.
�j� ti
Application by the undersigned is hereby made to connect with -the town sewer main in �O>r�l� Street,
subject to the rules and regulations of the Division of Public Works.
The premises are.known as No. Street
oP •subdivision lot no
Owner Address®
I � •
Contractor Address
€a « t (I W. iu•,F#•.r `;.t Applicant's Signature
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€T 3f'Ifrrt
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err# yl#u 1 ,w of trig oli�is�
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PERMIT TO CONNECT WITH SEWER MAIN
The Division of Public Works hereby grants permission to
to make a connection with the sewer main at
subject to the rules and regulations of the Division of Public Works..
Inspected by
Date
By
See back for rules and regulations
4)kl�e,S'' 50 ?- 3 T-).. D.6 F7
Street
Division of Public Works
APPLICATION FOR SEWER SERVICE CONNECTION
e-- Z.o0 1
North Andover, Mass. _p I att S 49g
Application by the undersigned is hereby made to connect with the town sewer main in c�0t,4-4 Street,
subject to the rules and regulations of the Division of Public Works. G(
The premises are known as No. z5o so u f-0 CrStreet
or subdivision lot no.
1Li Ca�i1 CL -Pa u Z7 d,
Owner
Contractor
co AJ 5 6Rv A'7-1 O /V
�G vyf (J
Address
Address
Applicant's Signature
27 (Lar"leS <6 --
PERMIT TO CONNECT WITH SEWER MAIN
The Division of Public Works hereby grants permission to
to make a connection with the sewer main at
subject to the rules and regulations of the Division of Public Works..
Inspected by
Date
By
See back for rules and regulations
Street
Division of Public Works
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AS -BUILT CHECKLIST
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
W/IN 150' OF SYSTEM
f� LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D -BOX
STAMP & SIGNATURE
IMPERVIOUS AREAS --DRIVEWAYS, ETC.
NORTH ARROW
FINAL CONTOURS
LOCATION & ELEVATION OF BENCHMARK USED
LOCUS PLAN
LOT NUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATION & DEMENSIONS OF SYSTEM,
INCLUDING RESERVE
TIES TO LOT LINES & DWELLING, WELLS
a. FROM SEPTIC TANK
b. FROM LEACH AREA
`
LOCATIONS OF DEEP HOLES & PERC
TESTS
ELEVATIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
W/IN 150' OF SYSTEM
f� LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D -BOX
STAMP & SIGNATURE
IMPERVIOUS AREAS --DRIVEWAYS, ETC.
NORTH ARROW
FINAL CONTOURS
LOCATION & ELEVATION OF BENCHMARK USED
LOCUS PLAN